Analysis of Immunohistochemical Expression of BRAF(V600E) Mutation in Serrated Colorectal Polyps - A Study from Tertiary Hospital in Oman

Sep 22, 2026

Colorectal cancer (CRC) is a leading malignancy worldwide, and serrated polyps are recognized precursor lesions in an alternative carcinogenic pathway. This study aimed to determine the prevalence of the BRAF (V600E) mutation in serrated colorectal polyps among the Omani population and to evaluate related features including type, site, and size, as well as associations between BRAF (V600E) status and polyp characteristics. Ninety-one hyperplastic polyps, sessile serrated lesions, and tubular adenomas with low-grade dysplasia were analyzed using BRAF (V600E) immunohistochemistry. BRAF (V600E) positivity was observed in the majority of hyperplastic polyps and in over half of sessile serrated lesions, with no positivity in adenomatous polyps.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Abstract

Background and Aim

Materials and Methods

Results

Conclusion

Keywords

RESEARCH ARTICLE Editorial Process: Submission:04/25/2024 Acceptance:07/13/2024 Analysis of Immunohistochemical Expression of BRAF(V600E) Mutation in Serrated Colorectal Polyps: A Study from Tertiary Hospital in Oman Abir Al Ghafri1, Shayma G Sayed2, Suaad Al Badi2, Afrah Al Rashdi2, Samya Al Husaini2, Asim Qureshi2, Asem Shalaby2,3 * Abstract Background and aim: Colorectal cancer (CRC) is considered one of the most common cancers in the world. Serrated polyps were found to be precursor lesions for CRC. BRAF mutation (V600E) has been strongly linked to the development of these lesions. No previous study concerning BRAF immunohistochemical expression in serrated polyps-was done in Oman. The primary objective of our study was to assess the prevalence of BRAF (V600E) mutation in serrated colorectal polyps in the Omani population. The secondary objectives were to assess the prevalence of serrated polyps and their characteristic features: type, site and size as well as the relationship between BRAF (V600E) mutation and polyp type, site and size. Materials and methods: Ninety-one hyperplastic polyps (HP) (76.5%), 24 sessile serrated lesions (SSL) (20.2%) and 4 cases of tubular adenomas with low grade dysplasia (3.4%) were studied for BRAF (V600E) immunohistochemical expression. No case of traditional serrated adenoma (TSA) was present. Control cases of craniopharyngioma and papillary thyroid carcinoma were included. Results: BRAF (V600E) IHC was positive in 63 of the HP polyps (69.2%), 13 SSLs (54.2%) and none of the adenomatous polyps. The majority of positive polyps (75.0%) were ≤5 mm in size, 17.9% were 5-10 mm and 7.1% were ≥10 mm in size. The majority of BRAF (V600E) positive polyps (68.1 %) were in the distal colon and 31.9 % were in the proximal colon. The majority of positive cases for BRAF (V600E) were showing multiple polyps (61.8 %) . None of the tubular adenomas showed any BRAF (V600E) positivity. Conclusion: Serrated polyps are now well known for their potential to develop CRC. Immunohistochemistry is an easy and reproducible way to detect BRAF (V600E) mutation. Our study showed there is high prevalence (64.3%) of BRAF mutation in serrated polyps in the Omani population. The majority of these polypswere HP and SSL; and ≤5 mm in size and located in the distal colon. Keywords: Colorectal cancer-colorectal polyp-serrated polyps-hyperplastic polyp-BRAF (V600E) mutation. Asian Pac J Cancer Prev, 25 (7), 2567-2571 Introduction Colorectal cancer (CRC) is the third most commonly diagnosed malignancy in the world [1] . In Oman, it is considered the second most common cancer among Omani males and the third most common cancer among Omani females, according to Oman Cancer Registry 2016 [2] . The initiation and progression of CRC is driven by a stepwise accumulation of genetic alterations. Thereis however considerable genetic heterogeneity, and tumor subtypes that evolve through different pathways. In the “classic” progression model, inactivation of the adenomatous polyposis coli (APC) gene is an early initiating event, followed by additional alterations, such as KRASandTP53 mutations. These classic tumors are more often located in the distal colon and rectum and genetically they frequently have chromosomal instability (CIN) . In this adenoma-carcinoma sequence, adenomatous polyps are the neoplastic precursor lesions ofadenocarcinoma [3] . Another type of colorectal polyps are the serrated polyps which are now believed to be precursor lesions to CRC through a distinct alternative pathway. Thirty years ago, these lesions were called “hyperplastic”polyps and were thought to have no malignant potential [4] . This concept was challenged by the observation of cancers developing inpatients with hyperplastic polyposis syndrome or in sporadically occurring hyperplastic polyps [5]. Serrated polyps represent in fact several sub-entities, some of which are precancerous. The latest World Health Organization classificatio

FAQs

What was the primary objective of the study?

To assess the prevalence of the BRAF (V600E) mutation in serrated colorectal polyps in the Omani population.

How was BRAF (V600E) mutation assessed in the polyps?

Using BRAF (V600E) immunohistochemical (IHC) expression analysis.

What were the main findings regarding BRAF (V600E) positivity?

BRAF (V600E) IHC was positive in most hyperplastic polyps and in about half of sessile serrated lesions, and none of the adenomatous polyps showed positivity.

Sep 22, 2026

Upload by River Wang